2025 HCPCS code V2203
(Active) Effective Date: N/A Revision Date: N/A Vision Services - Lenses, Bifocals Vision Services Feed
Spherocylindrical bifocal lens correcting near and distant vision, and astigmatism.
Modifiers may apply depending on the circumstances of service.Consult payer guidelines.
Medical necessity for V2203 is established by the presence of refractive errors (myopia, hyperopia, astigmatism), and the patient's need for correction to improve visual acuity and quality of life.Documentation must support the diagnosis and the appropriateness of bifocal correction.
Optometrist or ophthalmologist responsible for determining the patient's refractive error and prescribing the appropriate lens correction. Dispensing optician responsible for fitting and dispensing the lens.
In simple words: This code is for a special type of eyeglass lens called a spherocylindrical bifocal lens. It has two parts to help you see things both near and far away, and also corrects for blurry vision caused by an uneven cornea shape.
This HCPCS code, V2203, represents a spherocylindrical bifocal lens.This type of lens has a spherical front surface (rounded) and a cylindrical back surface. The spherical portion is divided into upper and lower sections, correcting both near and farsightedness. The cylindrical portion corrects astigmatism.The correction is measured in diopters (D), ranging from plano (0.00D) to ±4.00D for the spherical portion and ±0.12D to ±2.00D for the cylindrical portion. The lens material is typically plastic or glass.
Example 1: A 60-year-old patient with presbyopia (age-related farsightedness) and astigmatism requires bifocal lenses to improve both near and distance vision.V2203 is used to bill for the spherocylindrical bifocal lenses provided., A 45-year-old patient with astigmatism and mild myopia (nearsightedness) needs bifocal correction for computer work and distance vision. V2203 is appropriate for billing purposes, specifying the correct diopter measurements., A patient with significant astigmatism and a need for bifocals is prescribed a high-powered spherocylindrical bifocal lens.The specific diopter range would require selection of a code from V2203 - V2214.
* Patient's prescription for the spherocylindrical bifocal lenses, including the specific diopter measurements.* Documentation of the patient's refractive error (e.g., ophthalmological examination report).* Documentation supporting the medical necessity for bifocal lenses (e.g., patient's symptoms, visual acuity testing).
** Ensure that the specific diopter measurements are accurately documented and billed.Different codes exist for different diopter ranges. If the diopter measurements are outside the range covered by V2203, a different code from the V2200-V2299 range may be more appropriate.
- Payment Status: Active
- Modifier TC rule: No TC modifier applicable.
- Specialties:Ophthalmology, Optometry, Optical Dispensing
- Place of Service:Office, Optical Dispensary